Low ferritin level?

I am almost two years out and my ferritin level is at an all time low. It started at 108 two years ago, 74 one year ago & now it's at 32! I don't know what to do! I take my vitamins and even added extra iron. My iron serum came back okay. It's at 139. Any ideas of what I should do? I have my two year post op appointment in 12 days.

That seems to be pretty common, that it falls over time.

I'm five years out (in four days, I am five years out, anyway) and my ferritin has gone from 288 to 222 to 140 to 78 to 15.  Yes, when I had labs done in June, it was 15.  I upped my iron from 75 mg a day to 300 mg a day and when I had it checked a month ago, it had gone up to 26.

32 isn't a super worrisome number, although it's on the low side.  What is worrisome, though, is how it's steadily dropping.  At this rate, you could expect it to be under 10 in the next six to 12 months, which is iron infusion territory.

All I can suggest is to increase your iron. 

There is a good chance your doc will tell you 32 is OK, especially since your iron serum is good.  Heck, mine told me my ferritin was OK at 15, but I disagreed.

How much iron are you currently taking?  What kind?  Do you take vitamin C with it?  You are taking it at least two hours away from calcium, right?

At 32, it's not likely that it's causing you any symptoms.  If it gets much lower, though, you start getting pretty tired.

Thanks for answering so quickly! I was hoping you would answer!

Okay, so I take my iron early in the morning way before I take anything else. I take 28mg of iron fumarate. (It says iron fumarate, iron amino acid chelate iron citrate). I take it with vitamin c. This is aside from the iron in my multi vitamin which has 18mg. I take that twice a day.

OK.  Ferrous fumerate is only 33% elemental iron so 28 mg of that only gives you 9.24 mg of elemental iron.  The rest is iron salts.  So that's a teeny tiny dose.

What kind of iron is in your multi?

The bottom line is that you're on a really small dose of iron.  I'd increase it.  A lot.

It's the same kind. Ferrous fumerate. So what kind should I be taking to get the most out of it?

I like carbonyl because it's all elemental iron and it rarely causes constipation.  That's because it's all elemental iron - it's the iron salts in the other stuff that tend to cause constipation.

Ferrous sulfate and ferrous gluconate have less elemental iron than ferrous fumerate.  I'd go with carbonyl.

Thank you so much! I'm gonna go buy some right now!

I have the same questions as Kelly. You may need to increase iron, try a different type. 

it's it's not uncommon to see ferritin and iron to drop. I thought I was safe after a complete hysterectomy but it didn't happen. I've had infusions twice with last labs good so none currently needed. Mine last about 18 months it appears. 

My ferritin was low even before surgery.  It dropped pathetically low before my one year anniversary.  I now take between 150 to 180 mg of carbonyl iron daily.   I take it with 1000mg of vitamin C.   This dose has helped my ferritin to go up, but in very small increments.   But Kelly is right, it doesn't cause me constipation issues, so for that alone, the carbonyl is wonderful.

Do you think that we should take extra iron just as a preventive measure to avoid the drop in the first place?  I'm doing the doc prescribed Bariatric Advantage

Nutrient	Amount		%DV
Iron (Ferronyl® carbonyl iron)	29	mg	161%
Vitamin C	60	mg	100%

...but added 1000 mg vitamin C with it.   It seems like it would be better to keep the levels up rather than try to play catch-up later.